Ziemer et al compared a simple meal plan emphasizing healthy food choices with a traditional exchange-based meal plan for urban African Americans with type 2 diabetes. A total of 648 patients with type 2 diabetes were randomized to receive instruction on either of the meal plan to compare the impact on glycemic control, weight loss, serum lipids, and blood pressure at 6 months of follow-up. It was found that medical nutrition therapy was effective in urban African Americans with type 2 diabetes and that either a meal plan emphasizing guidelines for healthy food choices or a low literacy exchange method was equally effective as a meal planning approach.